Several commercial medicaments in the form of pancreatic enzyme supplements are known for the treatment of pancreatic exocrine insufficiency. The active ingredients of these products are digestive enzymes, mainly amylase, lipase and protease, which are normally produced in the pancreas and excreted to the upper part of the small intestine (the duodenum). The enzymes used in such medicaments derive from bovine or swine pancreas, however there are also products on the market with microbial enzymes, e.g. the product Nortase® which contains a lipase from Rhizopus oryzae, a protease from Aspergillus oryzae, and an amylase from Aspergillus oryzae. 
U.S. Pat. No. 5,614,189 (EP 600868) describes the use of, i.a., a lipase derived from Humicola lanuginosa in pancreatic enzyme replacement therapy, for example in the treatment of patients suffering from cystic fibrosis. This lipase is from Humicola lanuginosa DSM 4109 and has the amino acid sequence of amino acids 1-269 of SEQ ID NO: 9 herein.
WO 00/54799 describes the use of physiologically acceptable enzyme mixtures having lipolytic, proteolytic and amylolytic activity in the treatment of diabetes mellitus type I and II.
WO 02/060474 describes the use of a concentrated lipase from Rhizopus delemar, a neutral protease from Aspergillus melleus, and an amylase from Aspergillus oryzae in the treatment of maldigestion.
WO 01/62280 describes the use of a non-fungal lipase crystal crosslinked with a multifunctional crosslinking agent, a protease, and an amylase, wherein the lipase crystal is active at a pH range from about 2.0 to 9.0, for treating or preventing a gastrointestinal disorder in a mammal. A preferred lipase is from Pseudomonas, preferred amylases are from Aspergillus and Bacillus, preferred proteases are bromelain, papain or ficin.
EP 0828509 describes the use of certain acid-stable amylases, optionally in combination with certain acid-stable lipases and/or proteases, in the treatment of exocrine pancreas insufficiency. A preferred amylase is from Aspergillus niger, and preferred lipases are from Rhizopus arrhizus or Rhizopus javanicus. 
WO 99/19467 describes certain variants of alpha-amylases derived from Bacillus stearothermophilus, Bacillus licheniformis, and Bacillus amyloliquefaciens, as well as various industrial uses thereof, however not the pharmaceutical use. The sequences of these wildtype Bacillus alpha-amylases designated SEQ ID NOs: 3-5 in WO 99/19467 are included herein as SEQ ID NOs: 10-12, respectively.
EP 0594235 describes a method for preparing purified amylase from a fermentation broth. A pharmaceutical composition is also claimed, and a potential use as digestive aid is mentioned, along with other potential uses. The examples illustrate the claimed purification method for a Bacillus licheniformis alpha-amylase.
WO 2004/078960 discloses a method for identifying at least one T-cell epitope of an amylase and variant amylases comprising at least one alteration in at least one epitope. Many potential uses are enumerated, including the pharmaceutical use. An amylase from Bacillus licheniformis is referred to.
EP 0828509 describes the use of certain acid-stable amylases, optionally in combination with certain acid-stable lipases and/or proteases, in the treatment of exocrine pancreas insufficiency. A preferred amylase is from Aspergillus niger, and preferred lipases are from Rhizopus arrhizus or Rhizopus javanicus. 
There is a need in the art for alternative, preferably improved, enzymes for pharmaceutical use.